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I guess it depends on what you look for with regards to gore.
If you are talking purely in the volume of blood and mangled human tissue, then films like Dead Alive and Premutos are leaders.
I can't remember the exact figures, but if I recall correctly, Premutos had well over 100 kills.
However, to me Gore is more than just showing buckets of blood. For it to be effective, it has to make the viewer feel uncomfortable, provoke a visceral response.
There are movies with far less gore that provoke a much greater visceral response. For example, Irreversible. There are only a few "gore" scenes - the fire extinguisher/broken arm scene, the beating of the main character after she is raped. However, the fire extinguisher/broken arm scene alone provoked a much greater visceral response for me than Dead Alive and Premutos together.
The problem with many Hollywood productions is that they try to push the envelope and outdo their contemporaries, however still have to walk a fine line to keep within the boundaries of an R rating. Therefore, they need to have something more than just gore to be a memorable or interesting film (indie films or foreign films that don't care about the MPAA R rating can outdo them in gore).
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